Provider Demographics
NPI:1831752542
Name:GRANT CARE SERVICES LLC
Entity type:Organization
Organization Name:GRANT CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:813-466-8793
Mailing Address - Street 1:10120 MAJESTIC PALM CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-9435
Mailing Address - Country:US
Mailing Address - Phone:813-466-8793
Mailing Address - Fax:
Practice Address - Street 1:10120 MAJESTIC PALM CIR APT 202
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-9435
Practice Address - Country:US
Practice Address - Phone:813-466-8793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care